Category: Pregnancy

Three blister packs of birth control pills on a pink background.

Opill’s FDA Approval: Implications for Pharmaceutical Regulation and Access to Care

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By James René Jolin and Susannah Baruch

On July 13, 2023, the United States Food and Drug Administration (FDA) approved Opill (norgestrel) as the first daily oral contraceptive available for non-prescription use in the U.S. While the timeline for availability and price of Opill will ultimately be set by its manufacturer, Perrigo, this recent move represents a significant step forward in improving access to contraceptive health care. Indeed, shortly after Opill’s approval, the American College of Obstetricians and Gynecologists described the FDA’s decision as “a critically important advancement in the accessibility of reproductive health care.”

In response to this development, Petrie-Flom Center intern James René Jolin and Executive Director Susannah Baruch sat down to discuss its legal, regulatory, and public health implications. This interview has been edited for brevity and clarity.

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Newborn infant incubator boxes in a hospital corridor.

Neonatal Care (Leave and Pay) Act 2023: Some Questions Raised by Artificial Amniotic and Placenta Technology

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By Anna Nelson

Traditionally, maternity and other parental leave protections have been predicated on expectations of linear and uncomplicated experience of birth. This has created challenges when babies are required to spend time in Neonatal Intensive Care Units (NICU), especially where these stays are prolonged. In response to these concerns the UK recently passed the Neonatal Care (Leave and Pay) Act 2023.

The passing of the Neonatal Care (Leave and Pay) Act 2023 was a significant step forward in labor law rights for those whose infants require a hospital stay upon delivery (though the provisions within it are not expected to come into effect until April 2025). This Act created statutory entitlement to up to 12 weeks of neonatal care leave, and pay for qualifying parents, as well as providing protection from redundancy during this time. While the right to neonatal care leave is a “day one right,” the statutory right to Neonatal Care pay will be contingent upon meeting minimum service (26 weeks) and pay criteria. This means that not all parents will be protected from the financial worries associated with taking leave during their child’s stay in hospital.

In this blog, I will look at whether the protections within this Act would be sufficient if Artificial Amniotic and Placenta Technology (AAPT) were to become available for use in humans. AAPT, sometimes called “artificial womb technology,” is a developing technological innovation which would “closely reproduce[s] the environment of the womb” so as to support neonatal maturation, and reduce the mortality and morbidity rates associated with extremely premature birth. This is an expansive topic, and the purpose of this blog is to identify some key considerations and questions rather than to provide comprehensive answers!

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Conceiving a New Interpretation of Equality Law for Those Undergoing Fertility Treatments

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By Michelle Weldon-Johns

An increasing number of people in the UK undergo assisted reproductive technology (ART) treatments annually to conceive or to preserve fertility. HFEA data show that in the UK in 2019, nearly 53,000 persons received 68,975 cycles of IVF, 5,694 cycles of donor insemination treatment, 2,396 egg freeze cycles and 8,174 embryos were stored. This has significant implications for working persons, with the requirements to attend often time-sensitive appointments and undergo, at times, invasive fertility treatments that have an impact on availability for work, not to mention physical and mental effects. Nevertheless, those engaged in ART treatment find themselves outside the traditional boundaries of equality law protection. This is concerning given the potential for treatment to interfere with work and/or workplace performance, and their resulting vulnerability to discrimination and/or dismissal.

The UK Equality Act 2010 extends protection only to those who satisfy one of nine specific protected characteristics, with sex, pregnancy and maternity, and disability most relevant here. However, none of these characteristics alone offers sufficient protection for all those engaged in ART treatments. Nevertheless, equality law offers some possibilities for the future if developed appropriately.

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The Problems with Employer-Funded Elective Egg Freezing

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By Kathleen (Katie) Hammond

We have seen a growing trend in recent years of companies covering some, or all, of the cost of elective (i.e., non-medical) egg freezing as an employee benefit. For instance, Meta, Google, Netflix, Uber, and Apple are among the list of companies that offer some coverage for elective egg freezing.

In this piece, I explore four concerns with employer-funded elective egg freezing. While there are many upsides, employers should be mindful of how funding egg freezing may impact workplace culture. They should be careful about how information about the procedure is disseminated, and they need to be careful not to discriminate in regards to who can access it. Additionally, employer-funded elective egg freezing is not a replacement for other institutional benefits that foster workplace equality and parenthood-work balance such as paid parental leave, flexible work schedules, and funding for childcare.

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figurine with a void shape of a child and family of parents with a child. Surrogacy concept.

Forced Gifting: English Surrogacy, Gestational Labor, and the Inequality of Choice

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By Lucas Taylor

Surrogacy, the practice in which one party (the surrogate) gestates a fetus on behalf of another pair/person (the intended parent/s or IPs), has sparked academic debates regarding gender equality and bodily integrity in the face of both commercial and altruistic agreements. I re-engage with this topic by challenging how the capacity of the surrogate to choose may be restricted under English and Welsh law. This post does not seek to argue against the practice of altruistic surrogacy. Instead, it seeks to highlight, through the lens of Social Reproduction Theory, that central to the legal framework is a highly gendered devaluation of labor which undermines the potential for surrogates to fully exercise choice in relation to their gestational labor.

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Access to Reproductive Technology May Be Impeded by Workplace Law and Policy in South Africa

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By Sheetal Soni

In this post, I will consider the position of assisted reproductive technologies (ARTs) under South African law, as well as the challenges posed by legislation and policy.

Broadly speaking, ARTs have made it possible for people to create and expand their families where this was previously not possible. Obstacles to reproducing include natural barriers such as infertility, or being single or in a same-sex relationship. Options such as gamete donation, surrogacy, intra-cytoplasmic sperm injection and other technologies have allowed infertile individuals to better the odds of reproducing. However, as beneficial as these ART options may be, there are other barriers to creating that family; in South Africa, these barriers include unequal access to treatment, as well as workplace laws and policies that dissuade and discourage people from seeking treatment.

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A Good Man is Hard to Find: Egg Freezing and the ‘Mating Gap’

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By Karey Harwood

For as long as I have been thinking and writing about egg freezing, its characterization as “a technological solution to a social problem” has adumbrated a core criticism: egg freezing falls short because there is a deeper problem it doesn’t solve. Egg freezing may help the individual woman who can afford it, yes, but not much more. The deeper problem is generally assumed to be workplace norms molded around men’s life cycle. Pushing hard to advance one’s career during one’s 20s and 30s does not cost men the opportunity to father children, primarily because their fertility does not decline precipitously after age 35. In addition, stay-at-home wives have historically played a supportive role in freeing up men to focus on work. By contrast, women have a more limited window of fertility and are not as likely to have a stay-at-home partner who can take primary responsibility for childrearing.

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